CORONAVIRUS (COVID-19)
IMAJ | volume 25
Journal 9, September 2023
pages: 590-594
Humoral Response of Different Types of SARS-CoV-2 Vaccines in Patients with Autoimmune Rheumatic Diseases: Experiences from a Serbian Cohort
1 Special Hospital "Dr Zutic", Belgrade University, Belgrade, Serbia
2 Department of Hematology, University Hospital Medical Center Bezanijska Kosa, Belgrade, Serbia
3 Department of Cardiology, University Hospital Medical Center Bezanijska Kosa, Belgrade, Serbia
4 Faculty of Medicine, Belgrade University, Belgrade, Serbia
5 Infectology Clinic, Military Medical Academy, Belgrade, Serbia
6 Clinic of Cardiology, University Clinical Center of Serbia, Belgrade, Serbia
7 Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel
8 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Summary
Background:
Data are scarce on the immunogenicity of coronavirus disease 2019 vaccines in patients with autoimmune rheumatic diseases (ARD).
Objectives:
To measure the immunoglobulin G (IgG) response after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunization and to evaluate clinical characteristics associated with seropositivity.
Methods:
Samples were collected after the second and third doses of the three different types of vaccines in ARD patients. Seroconversion rates and IgG antibody S1/S2 titers were measured.
Results:
The type of ARD diagnosis and previous treatment had no significant impact on the serum IgG antibody levels measured after the second (
P = 0.489 and
P = 0.330, respectively) and boost dose (
P = 0.441 and
P = 0.446, respectively). What made a significant difference regarding serum IgG antibody levels after the second dose was the type of SARS-CoV-2 vaccine. The difference was highly statistically significant for all vaccine types (
P = 0.001 with the highest odds ratio for the mRNA vaccine). After the boost with the mRNA vaccine, all patients achieved a high level of serum IgG antibody levels (
t = 10.31,
P = 0.001). No ARD patients experienced serious post-vaccinal reactions. Eight patients developed COVID-19 before the boost dose.
Conclusions:
In ARDs patients, the highest level of serum IgG antibody against S1/S2 proteins was achieved with the mRNA vaccine, irrespective of the therapy applied or the type of the disease. We recommend a booster dose with mRNA vaccine in all ARDs for the highest SARS-CoV-2 protection without serious post-vaccinal reactions observed.